tbuckley/cabot-search huggingface dataset:
Factors associated with readmission to the same hospital within 30 days of discharge in patients who received surgical treatment for head and neck cancer: An NCDB analysis.
Authors: Kiana Verplancke, Peter T. Silberstein, Darby Keirns
Journal: Journal of Clinical Oncology (2023)

e18570 Background: Readmission rates within 30-days of discharge is an important quality metric when caring for hospitalized patients. Higher rates of readmission are a predictor of all-cause mortality and associated with negative financial implications for hospitals. Patients undergoing surgery for the treatment of head and neck cancer have readmission rates ranging from 7.3% to 26.5%. The benefits to the patient and the hospital highlight the importance of determining if certain patient features impact the likelihood of readmission. This study sought to determine if certain socioeconomic and demographic factors are associated with higher 30-day readmission rates following surgically treated head and neck cancers. Methods: Using the National Cancer Database, 221,822 patients were identified as having surgically treated head and neck cancer between 2004 and 2020. Using SPSS statistics 28, 30-day readmission rates for these patients were compared to each other based on certain characteristics including sex, race, ethnicity, insurance status, income, and facility type. Results were analyzed using descriptive statistics, a multivariate binary logistic regression, and chi-square analyses using a significance level of p &lt; 0.05. Results: Higher 30-day readmission rates in patients with certain demographic and socioeconomic factors were identified. Black and Asian patients had higher readmission rates in comparison to white patients (p &lt; .001, 95% CI = 1.24-1.41 and 1.08-1.30, respectively). Patients of Hispanic backgrounds were 25% more likely to be readmitted than non-Hispanic patients (p &lt; .001, 95% CI = 1.15-1.34). Males had a 13% higher readmission rate than females (p &lt; .001, 95% CI = 1.09-1.17). Uninsured patients were more likely to be readmitted than those with some form of insurance (p &lt; .001). Those with a median annual income less than $46,277 were 11% more likely to be readmitted than those who had a median annual income higher than $46,277 (p &lt; .001). In comparison to those treated at a community cancer program, patients who received treatment at academic/research programs or integrated network cancer programs were 32% and 21% more likely to be readmitted, respectively (p &lt; .001, 95% CI = 1.20-1.45 and 1.10-1.34, respectively). Conclusions: Patients who are more likely to be readmitted to the same hospital within 30-days of being surgically treated for head and neck cancers include black patients, Asians, those of Hispanic descent, males, the uninsured, those with a lower median annual income, and those who received surgical treatment at academic/research programs or integrated network cancer programs. Identification of factors contributing to readmission allows for development of targeted interventions to prevent this occurrence.
Homologous recombination deficiency (HRD) status and response to platinum-based chemotherapy and PARP inhibitors in Chinese patients with ovarian cancer.
Authors: Hua Yuan, Ning Li, Lingying Wu, Hongwen Yao
Journal: Journal of Clinical Oncology (2023)

e17533 Background: The association between platinum-based chemotherapy and PARPis response and HRD status in Chinese epithelial ovarian cancer patients has not been fully elucidated. Methods: We assessed homologous recombination deficiency (HRD) score using genomic scar analysis (GSA) algorithm of Beijing Genomics Institute (BGI) assay. The definitive HRD status were determined by combining HRD score tested with the BGI assay and homologous recombination repair (HRR) gene mutation status. We then tested the association of HRD with response to platinum-based chemotherapy and PARP inhibitors in Chinese patients with ovarian cancer. Results: In total, 209 patients with definitive HRD status were included: 66.0% (138 of 209) for HRD and 34.0% (71 of 209) for non-HRD. Patients with HRD tumors were more likely to have a larger tumor (73.9% vs 59.2%, P = 0.029), and less likely to receive neoadjuvant chemotherapy (48.6% vs 67.6%, P = 0.009). No differences were found between patients with HRD and non-HRD tumors in age at diagnosis, histology, stage, postoperative residual disease status. In the entire cohort, patients with HRD tumors were more likely to be platinum sensitive with a platinum-free interval (PFI) of &gt; 6 months than those with non-HRD (79.6% vs 65.7%, P=0.030). Patients with HRD had a significantly better PFS and OS than patients with non-HRD in the entire study population (PFS: unadjusted HR = 0.54, 95% CI: 0.38–0.77, P = 0.001; and OS: unadjusted HR = 0.44, 95% CI: 0.26–0.75, P = 0.002). Multivariate analysis showed that patients with HRD was an independent predictor of increased PFS and OS (PFS: HR = 0.56, 95% CI: 0.39-0.82, P = 0.002; OS: HR = 0.50, 95% CI: 0.29-0.86, P = 0.012). In patients who received PARPis as first-line maintenance (n=55), the median duration of PARPis was 23.3 months (1.2-40.0 months) and 11.0 months (1.4-39.1 months) in HRD and non-HRD subgroup, respectively. Patients with HRD had a significantly better PFS than non-HRD patients (median PFS: NR vs 22.5 months, unadjusted HR = 0.39, 95% CI: 0.16-0.97, P = 0.035). Multivariate analysis showed that patients with HRD was an independent predictor of increased PFS (HR = 0.22, 95% CI: 0.07-0.68, P = 0.008). Conclusions: Patients with HRD tumors are more likely to respond to platinum-based chemotherapy and PARPis when compared with those who are non-HRD. HRD tumors associate with a better survival in Chinese ovarian cancer patient.
Impact of hemoglobin on survival of young women with cervical cancer treated with concurrent chemoradiotherapy.
Authors: Melanie Wendy Castro-Mollo, Marco Galvez-Nino, Rossana Ruiz, Katia Roque, Ofelia Coanqui, Natalia Valdivieso, Mivael Olivera Hurtado de Mendoza, Luis Mas
Journal: Journal of Clinical Oncology (2023)

e17529 Background: Cervical cancer is a global public health problem, with higher impact in many low-income and middle income countries. In Peru, cervical cancer is the leading cause of cancer deaths among women. The aim of this study is to investigate the prognostic factors affecting long-term survival in locally advanced cervical cancer young patients treated with concurrent chemoradiotherapy. Methods: This is a retrospective study of young women with locally advanced cervical cancer who underwent radiotherapy with concurrent platinum-based chemotherapy at the national cancer peruvian institute (INEN), from 2008 to 2012. The clinicopathological factors of all patients were collected. To explore the relationship between factors and prognosis, survival rates were estimated by the Kaplan–Meier method. Results: A total of 192 patients under 35 years old . Among all patients, 167 were diagnosed with SCC, 19 with AC, and 5 with ASC. Most of the patients were IIB and IIIB FIGO stage, 69% and 22% respectively. 38 cases had no metastatic lymph nodes and 42 cases were diagnosed of lymph node metastases, of which 30 were positive for pelvic lymph nodes only, and 12 were positive for para-aortic lymph nodes. We obtained pretreatment hemoglobin levels for all patients and found a median of 111 g/L, also we calculated the Prognostic nutritional index (PNI) with a median of 41.87 that correlates with a moderate to severe malnutrition in patients prior treatment. Response to chemoradiotherapy was not available in 13 patients, 136 achieved complete response, 30 patients with persistent disease and 12 with disease progression. Estimated median OS of all patients was 114.1 months [101.8-126.4] and median DFS was 112.3 months [98.9-125.7]. Exploratory analysis was performed to determine potential prognostic factors, only hemoglobin ≤ 100 g/L was statistically significant (p = 0.007). Conclusions: In young patients undergoing chemoradiation for cervical carcinoma, the hemoglobin prior treatment is prognostically significant.
Combinatorial analysis of CD4<sup>+</sup>Tregs and CD8<sup>+</sup>Teff to predict response to ICI in patients with ES-SCLC.
Authors: Konstantinos Tsapakidis, Anastasia Xagara, Alexandros Kokkalis, Alexandra Markou, Chrysovalantis Aidarinis, Alexandros Lazarou, Galatea Kallergi, Vasileios Papadopoulos, Emmanouil S. Saloustros, Ioannis Samaras, Athanasios Kotsakis
Journal: Journal of Clinical Oncology (2023)

e20633 Background: Recently, the antiPD-L1 agent, durvalumab, was approved in first line treatment in combination with chemo. However, there is not a clear benefit from this regimen for the majority of patients. In this study, we explored the predictive role of regulatory T-cells in response of patients with ES-SCLC treated with the aforementioned regimen. Moreover, we evaluated the potential role of inflammatory hematological indices such as Neutrophil to Lymphocyte ratio (NLR) and CRP levels to predict responders. Methods: Blood was collected before initiation of immunotherapy from 24 patients with ES-SCLC. PBMCs were isolated with Ficoll density gradient centrifugation from patients and 1O healthy donors (HD). Immunophenotyping was performed by multi-color flow cytometry using antibodies against CD3,CD8,CD45RA,CD45RO,CCR7,PD-1, for CD8 T-cells and CD3,CD4,FoxP3,CD25,CD127,CTLA-4,CD39 for Tregs. Results: High percentages of CD39+ (p = 0.0061) and CTLA-4+ (p = 0.012) Tregs were detected in circulation of ES-SCLC compared to healthy individuals. Additionally, higher percentages of CD8+ Teff were detected in SCLC patients (p = 0.027). Patients with high numbers of Teff had significant higher PFS (p = 0.021, median 183 and 97 days) and better OS (p = 0.075, median 318 and 202 days) in response to immunotherapy compared to those with low numbers. Spearman analysis revealed a significant negative correlation between Tregs and Teff (Spearman r 2 = -0.39,p = 0.043) that was accompanied with significant higher PFS (p = 0.041, median 207 and 130 days ) and OS (p = 0.029, median 318 and 202 days ) in patients with high levels of Teff and low Tregs comparing to the rest. Further analysis on inflammatory clinical signatures demonstrated that patients with better clinical response to immunotherapy have significantly lower NLR (p = 0.034) while no significant difference was revealed for CRP (p = 0.401) levels before therapy initiation. Conclusions: Combinatorial analysis of Tregs and Teff cells may be used as a predictive tool for response to immunotherapy in ES-SCLC patients.
Financial toxicity and quality of life in patients undergoing bone marrow transplant evaluation: A single center analysis.
Authors: S. M. Qasim Hussaini, Yi Ren, Alessandro Racioppi, Meagan Lew, Lauren M. Bohannon, Ernaya Johnson, Jillian Thompson, Bethany Henshall, Maurisa Darby, Taewoong Choi, Richard D Lopez, Stefanie Sarantopoulos, Cristina J. Gasparetto, Gwynn Douglas Long, Mitchell Horwitz, Nelson Jen An Chao, Yousuf Zafar, Anthony Derek Sung
Journal: Journal of Clinical Oncology (2023)

7052 Background: The impact of pre-transplant financial toxicity on quality of life (QOL) outcomes following bone marrow transplant (BMT) is unknown. We investigated the prevalence of financial toxicity in a population undergoing evaluation for BMT and its impact on post-transplant clinical and health-related QOL outcomes. Methods: This is a cross-sectional study in patients undergoing evaluation for allogeneic BMT between 1/1/2018 and 9/23/2020 at a large academic medical center. Financial health at baseline was measured via the comprehensive score for financial toxicity (COST) survey. The cohort was divided into three groups: none, mild, and moderate-high financial toxicity. QOL was measured using Functional Assessment of Cancer Therapy (FACT)-based questionnaires at multiple timepoints. Multivariate logistic regression analysis evaluated factors associated with financial toxicity. Kaplan-Meier curves and log-rank tests evaluated overall survival and non-relapse survival. Results: Of 245 patients evaluated for BMT, 176 (71.8%) completed both questionnaires with 63.1% male, 72.2% white, and median age 57 years. Common diagnoses were myelodysplastic syndrome (39.2%), leukemia (38.1%), and lymphoma (13.6%). Overall, 83 (47.2%) patients reported no financial toxicity, 51 (29.0%) mild, and 42 (23.9%) with moderate-high financial toxicity at initial evaluation for BMT. Compared to those with no financial toxicity, those with mild or moderate-high financial toxicity reported significantly reduced spending on leisure, food/clothing, used all or a portion of savings, borrowed money or accumulated debt using a credit card, and did not fill a prescription due to costs (p &lt; 0.0001 for all). In patients with baseline moderate-high financial toxicity, FACT-BMT scores were lower at 6 months (126 none vs 122 mild vs 92 moderate-high; p = 0.0007) and 1 year (133 none vs 117 mild vs 112 moderate-high; p = 0.0075) following BMT. Older age (&gt;62) (OR 0.4; 95% CI [0.17 – 0.94], p = 0.03) and income equal or greater than $60,000 (OR 0.16; 95% CI [0.07 – 0.36], p = &lt; 0.001) were associated with lower odds of financial toxicity. No association was noted between financial toxicity and selection for BMT, overall survival, or non-relapse mortality. Conclusions: Financial toxicity was highly correlated with patient-reported changes in behavior affecting their daily activities and transplant care, with notable impact on QOL following transplant for up to 1 year. Early interventions by physician and social work-led teams may benefit patients who are at risk for financial toxicity. [Table: see text]
Associations between androgen-directed treatments and <i>AR </i>mutational landscapes in the circulating tumor DNA of a real-world metastatic prostate cancer cohort.
Authors: Elisa M. Ledet, Arockia Jayaraj, Ellen B. Jaeger, Melissa Conrad Stoppler, Minqi Huang, Calvin Y. Chao, A. Oliver Sartor
Journal: Journal of Clinical Oncology (2023)

5061 Background: AR alterations evolve under the selective pressure of testosterone suppression and AR targeted agents. In metastatic, castration-resistant prostate cancer (mCRPC) AR’s mutational landscape and therapeutics targeting is still an unexplored area. Here we evaluate AR mutations in the circulating tumor DNA (ctDNA) of patients treated with AR targeted agents such as abiraterone (abi), enzalutamide (enza) and in combination (abi + enza) setting in a large Tempus real-world mCRPC cohort. Methods: De-identified records of patients with mPC who underwent Tempus xF next-generation sequencing (NGS) ≥ 6 months after treatment initiation of abi, enza, or abi + enza were selected for analysis. If patients had multiple NGS samples, the most recent sample was used. The assay is a targeted liquid biopsy panel that detects single-nucleotide variants and insertions and/or deletions in 105 genes, copy number variants in six genes, and chromosomal rearrangements in seven genes. Results: The cohort included 1,122 patients treated with abi only (n=483), enza only (n=374), or prior exposure to abi + enza (n=265). Pathogenic/likely pathogenic mutations were detected in 15% (n=71) of patients treated with abi,15% (n=56) treated with enza, and 27% (n=71; P&lt;0.001) treated with both.The most frequent AR alterations were L702H (18%, 32%, and 25%) and T878A (34%, 3.6%, and 21%) and H875Y (7%, 12%, and 8.5%) in abi, enza, and abi + enza, respectively (Table). L702H and T878A alterations were found in an additional 8.5%, 3.6% and 9.9% of patients treated with abi, enza, or abi + enza, respectively. Alterations in L702A and H875T were found in 2.8%, 8.9% and 9.9% of patients treated with abi, enza, and abi + enza respectively. Approximately 4.2%, 1.8% and 1.4% (abi, enza, abi +enza) of treated patients had alterations in T878A and H875Y. Other single-hit alterations included 6 patients with W742C and 4 patients with F877L. Conclusions: AR mutations have implications for clinical decision making and drug development in patients treated with abiraterone and/or enzalutamide. [Table: see text]
Comparison of the genomic profiles of primary and recurrent lesions in patients with advanced bladder carcinomas.
Authors: Lijuan Chen, Guomin Lin, Fei Pang
Journal: Journal of Clinical Oncology (2023)

e16575 Background: Bladder carcinomas (BCs) is featured by high incidence of recurrence which remains to be a big clinical challenge. This study aimed to compare the genomic profiles of primary and recurrent BCs in advanced stage. Methods: Primary and recurrent tissues (and control blood) were collected and somatic variants including short variants, copy number variations, gene rearrangements and TMB (Tumor Mutation Burden) were analyzed following the CAP/CLIA-certificated workflows. Chi-Square Test/Fisher Test was applied to compare the difference between two variables. Results: To eliminate the impact of stage, only patients in advanced stages were included (stage III-IV) in this study. 53 patients were investigated, including 43 primary and 10 recurrent (evidence of tumor observed after radical treatment). It should be noted that matched primary and recurrent samples were not obtained from the same patient. Median age of the patients was 64 years old. The proportion of male patients was 86% (n = 37) in the primary cohort and 60% (n = 6) in the recurrent cohort. Among the primary cases, the most frequent alterations were detected in TP53 (58.1%), TERT (51.2%), KMT2D (27.9%), KDM6A (23.3%) and RB1 (23.3%). Among the recurrent cases, the most frequent alternations were showed in TERT (70%), KMT2D (50%), PIK3CA (50%), TP53 (50%) and KDM6A (40%). PIK3CA substitution and KRAS substitution showed significant difference when comparing between the two cohorts. PIK3CA substitution preferentially occurred in recurrent samples (50% recurrent vs 14% primary, p-value = 0.01), mostly occurred in E545K; while KRAS substitution showed 4.7% in primary and 30% in recurrent with p-value = 0.04, all presented as G12V. TMB showed no significant difference between the two cohorts (6.2 vs 6.3 muts/Mb, p-value = 0.72). Conclusions: By NGS, we observed that substitutions in PIK3CA and KRAS showed significant difference between primary and recurrent samples from advanced BCs patients. PIK3CA and KRAS mutations were reported to be associated with local recurrence in CRC, but no association was observed in early stage non-muscle-invasive BCs. Our findings may provide a different insight into the treatment selections for advanced BCs, although the sample size is small.
The impact of genetic predisposition to depression on quality of life in patients with head and neck cancer immediately post-treatment: A longitudinal study.
Authors: Melissa Henry, Lawrence Chen, Michael Meaney, Zeev Rosberger, Saul Frenkiel, Michael Hier, Anthony Zeitouni, Karen Kost, Alexander Mlynarek, Keith Richardson, Haley Deamond, Jacob Lang, Jennifer Silver, Laurence Ducharme, Marco Antonio Mascarella, Nader Sadeghi, Khalil Sultanem, George Shenouda, Fabio Cury, Kieran O'Donnell
Journal: Journal of Clinical Oncology (2023)

6063 Background: The primary aim of this study was to investigate the contribution of genetic predisposition to depression, through polygenic risk scores (PRS), on quality of life levels in patients with head and neck cancer (HNC) immediately post-treatment period (i.e., 3 months post-diagnosis). Methods: Prospective longitudinal study of 223 consecutive adult patients with HNC (72% participation) newly diagnosed with a first occurrence of primary HNC, including saliva samples analyzed using the Illumina PsychChip, psychometric measures, Structured Clinical DSM Interviews, and medical chart reviews. Results: Level of quality of life at 3 months on the FACT-G+H&amp;N was predicted by (r2 = 0.51, r2 adj. = 0.33, p = 0.001) the polygenic risk score for depression (standardized b = -0.28, p = 0.01) and a previous history of suicidal ideation (standardized b = -0.25, p = 0.04). Other variables were non-significant in the analyses: sociodemographic (i.e., age, sex, education, living alone), psychosocial (i.e., SCID current and past diagnoses (trend), past history of abuse), and medical variables (i.e., cancer stage and site, HPV status, functional status/ECOG, treatment). Conclusions: Our results outline the importance of attending to genetic predisposition and past history of suicidal ideation as markers for quality of life compromise immediately post-treatment in patients with head and neck cancers. Strategies are needed to address psychosocial vulnerability early-on as part of pre-habilitation in the treatment of patients with head and neck cancer.
Updated results from ALTER-H004 trial: Anlotinib combined with TACE as adjuvant therapy for patients with hepatocellular carcinoma at high risk of recurrence after surgery—A single arm, multi-center, phase II clinical trial.
Authors: Zheng Wu, Zheng Wang, Lei Zhang, Xiaojing Song
Journal: Journal of Clinical Oncology (2023)

e16222 Background: Hepatectomy is deemed as a curative treatment for patients (pts) with hepatocellular carcinoma (HCC). Unfortunately, high recurrent risk after curative resection compromised the long-term survival of HCC significantly. Transarterial chemoembolization (TACE) as adjuvant therapy was proved to improve therapeutic outcomes for pts with high recurrent risk after hepatectomy. However, the survival benefit of TACE remained unsatisfactory. ALTER-H004 trial was designed to identify the efficacy and safety of anlotinib as maintenance adjuvant treatment following TACE in pts with HCC. The preliminary results of ALTER-H004 had been reported at 2022 ASCO (e16120). Here we reported the results at the data cutoff of January 15, 2023. Methods: Pts with one of the following high risk factors after hepatectomy were eligible: ≥5cm and &lt;10cm of tumor diameter, tumor number ≥3, tumor microvascular invasion M1 or M2, portal vein tumor thrombus (Cheng's classification I/II). Eligible pts received conventional TACE treatment within 1-2 months after hepatectomy, and on the 4th day after TACE treatment, oral anlotinib (12mg, qd, 2 weeks on 1 week off) was given until disease recurrence or unacceptable toxicity. The predefined sample size was 30. The primary endpoint was disease free survival (DFS). Secondary endpoints included 1-year DFS rate, time to recurrence and safety. Results: At January 15, 2023, 29 pts were enrolled and 28 pts were available for prognostic assessment, among whom, 11 pts were still on treatment and 9 relapsed, 3 withdrew the consent, 5 discontinued own to intolerable adverse reactions. The longest duration of treatment is 27.83 months. The median DFS has not reached yet and the 1-year DFS rate was 76.46% (95% CI: 54.83~88.70) and 2-year DFS rate was 65.41% (95% CI: 41.70~81.39). Safety profile indicated that 18 pts (64.3%) experienced treatment-related adverse events (TRAEs). Grade 3 TRAEs were detected in 5 pts (17.9%) including hypertension (7.1%), leukocytopenia (7.1%) and ascites (3.6%). No grade 4 or 5 TRAEs were observed. Conclusions: Anlotinib combined with TACE as adjuvant therapy in pts with HCC at high recurrent risk exhibited promising prognosis and tolerable safety profile preliminarily, and the conclusion needed to be confirmed in large-scale clinical trials subsequently. Clinical trial information: NCT04213118 .